DOCSLIB.ORG

Exploding Head Syndrome: a Case Report

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Exploding Head Syndrome: a Case Report Case Report Annals of Clinical Case Reports Published: 20 May, 2019 Exploding Head Syndrome: A Case Report Muhannad Hawari* and Fayez Al-Ahmadi Department of Medicine, King Faisal Specialist Hospital and Research Center, Saudi Arabia Abstract Exploding Head Syndrome (EHS) is a rare type of a group of sleep disorders called parasomnias. It is characterized by the perception of a sudden loud noise in the head as the patient is falling asleep or awakening from sleep. The sound is described as a painless loud bang, an explosion, or a bomb exploding but can be a less alarming sound. We report a 60 years old lady with EHS describing this disorder and the assessment and management of it. Introduction Exploding Head Syndrome (EHS) is characterized by the perception of a sudden loud noise in the head as the patient is falling asleep or awakening from sleep [1,2]. The sound is described as a painless loud bang, an explosion, or a bomb [3]. It is classified as a type of parasomnia in the International Classification of Sleep Disorders (ICSD) 3rd edition and its pathophysiology is still unclear [3,4]. Armstrong-Jones first described it in 1920 [5]. Pearce coined the term ex ploding head syndrome in 1989 in a paper in which he described 40 patients with EHS [1]. Case Presentation We report this 60 years old lady known to have hypertension and dyslipidemia who presented complaining of poor quality of sleep for 2 years. Her sleep schedule was suggestive of a total sleep time of 7 h per night with usually a regular sleep-wake schedule. Her sleep environment and habits of sleep were not suggestive of anything to cause sleep disruption. She had history of snoring but no symptoms of restless leg syndrome or insomnia. She has no excessive daytime sleepiness (Epworth sleepiness scale was 4/24) and no symptoms to suggest an underlying neurological, psychiatric or medical disorders. She reports episodes of waking up at night with a loud sound in her head, which she could OPEN ACCESS not describe. The best description she was able to provide was “a loud sound as if blood is gushing *Correspondence: through my head”. It lasts for minutes and resolves spontaneously. It causes frequent awakenings at Muhannad Hawari, Department of night and sometimes she could not go to sleep. It was causing significant distress. Medicine, King Faisal Specialist Discussion Hospital and Research Center, Zahrawi St, Al Maather, Riyadh, 12713, Saudi Exploding Head Syndrome (EHS) is characterized by the perception of a sudden loud noise Arabia, Tel: 966504420248; in the head as the patient is falling asleep or awakening from sleep [1,2]. The sound is described E-mail: [email protected] as a painless loud bang, an explosion, or a bomb exploding but can be a less alarming sound [3]. Received Date: 22 Apr 2019 Occasionally; it is accompanied by the sensation of a flash of light. Accepted Date: 15 May 2019 Although these attacks themselves are usually not painful, it is reported that EHS attacks Published Date: 20 May 2019 may precede migraine as auras. EHS is classified as a type of parasomnia in the International rd Citation: Classification of Sleep Disorders (ICSD) 3 edition and its pathophysiology is still unclear [3,4]. It Hawari M, Al-Ahmadi F. Exploding Head was first described by Armstrong-Jones in 1920 [5]. The term exploding head syndrome was coined Syndrome: A Case Report. Ann Clin by Pearce in 1989 in a paper in which he described 40 patients with EHS [1]. It is thought to be a Case Rep. 2019; 4: 1658. migrainous phenomenon [1,6]. There have been different descriptions of the noise which include the sound of an explosion, gunshot, door slamming, roar, waves crashing against rocks, loud voices, ISSN: 2474-1655 a ringing noise, a terrific bang on a tin tray, or the sound of an electrical buzzing. In some cases, Copyright © 2019 Muhannad an instant flash of what is perceived as video ‘static’ is reported both audibly and visually for a Hawari. This is an open access fraction of a second [1,7]. It arises from the transition between different sleep stages and disappears article distributed under the Creative completely when awake, although it may recur on further sleep attempts [7]. There is no actual Commons Attribution License, which headache or persistent pain, but some patients may experience a brief, mild jab-like sensation. permits unrestricted use, distribution, and reproduction in any medium, Although EHS has been reported in patients as young as 10 years, the age of onset is usually provided the original work is properly after age 50 and the condition has a slight female preponderance. The attacks occur with variable cited. frequency for a few weeks or months. Attacks can be one-time events or can recur with attacks Remedy Publications LLC., | http://anncaserep.com/ 1 2019 | Volume 4 | Article 1658 Muhannad Hawari, et al., Annals of Clinical Case Reports - Neurology increasing or decreasing over time, sometimes with no incidents over 3. Michael J Sateia. International classification of sleep disorders- Third long periods of time [1,7,8]. The cause of EHS is unknown; however edition. 2014;146(5):1387-94. some possibilities include a sudden movement of a middle ear 4. Okura M, Miura R, Inoue M, Taniguchi M, Ohi M. Polysomnograhic component or the Eustachian tube, or a brief temporal lobe complex findings in five patients with exploding head syndrome. Sleep. partial seizure [9]. It may be related to emotional tenseness, as some 2017;40(1):A273. patients report a stressful life situation in periods' when attacks were 5. Armstrong-Jones R. Snapping of the brain. The Lancet. 1920;196(5066):720. intense and frequent [8]. There have been reports that the events might occur during stage N1 and N2 and maybe proceeded by 6. Palikh GM, Vaughn BV. Topiramate responsive exploding head syndrome. J Clin Sleep Med. 2010;6(4):382-3. respiratory events [4]. 7. Ganguly G, Mridha B, Khan A, Rison RA. Exploding head syndrome: a It is thought to be a benign phenomenon and reassurance is case report. Case Rep Neurol. 2013;5(1):14-7. usually needed. Pharmacological options include calcium channel blockers like nifedipine [10] or flunarizine [11], topiramate [6] and 8. Sachs C, Svanborg E. The exploding head syndrome: polysomnographic recordings and therapeutic suggestions. Sleep. 1991;14(3):263-6. clomipramine. All have been found to be effective in reducing the frequency or resolution of the EHS symptoms. 9. American Sleep Association: Exploding head syndrome. References 10. Jacome DE. Exploding head syndrome and idiopathic stabbing headache relieved by nifedipine. Cephalalgia. 2001;21(5):617-8. 1. Pearce JM. Clinical features of the exploding head syndrome. J Neurol Neurosurg Psychiatry. 1989;52(7):907-10. 11. Chakravarty A. Exploding head syndrome: report of two new cases. Cephalalgia. 2008;28(4):399-400. 2. John A Fleetham, Jonathan AE Fleming. Parasomnias. CMAJ. 2014;186(8):E273-80. Remedy Publications LLC., | http://anncaserep.com/ 2 2019 | Volume 4 | Article 1658.
Load more

Recommended publications
  • Parasomnias Revisited New Mexico Thoracic Society Sapna Bhatia Md 02/25/17 Objectives
    PARASOMNIAS REVISITED NEW MEXICO THORACIC SOCIETY SAPNA BHATIA MD 02/25/17 OBJECTIVES • Appreciate the clinical semiology to help differentiate between REM and NREM parasomnias • Appreciate the ICSD III Classification Scheme for the major parasomnias • Understand management modalities including behavioral and pharmacological for NREM and REM parasomnias • Understand the difference between parasomnias and seizures WHAT ARE PARASOMNIAS? Undesirable motor, or verbal phenomena that arise from sleep or sleep-wake transition PARASOMNIAS: OVERLAPPING STATES REM PARASOMNIAS WAKE NREM PARASOMNIAS REM NREM PARASOMNIAS: DIFFERENTIAL DIAGNOSIS RBD Confusional Arousals Recurrent Isolated Sleep Paralysis Sleepwalking Nightmare Disorder Sleep Terrors WAKE Sleep Related Eating Disorder REM NREM PYSCHOGENIC SEIZURES SPELLS NFLE Dissociative Disorder ICSD II ICSD III REM Parasomnias • RBD • RBD • Recurrent Isolated Sleep • Recurrent Isolated Sleep Paralysis ICSD II VS ICSDParalysis III CLASSIFICATION• Nightmare Disorder • Nightmare Disorder Disorders of arousal • Confusional Arousals • Confusional Arousals (NREM sleep) • Sleepwalking • Sleep Walking • Sleep Terrors • Sleep Terrors • SRED Other Parasomnias • SRED • Sleep Related Dissociative • Sleep Related Dissociative Disorders Disorders • Sleep Enuresis • Sleep Enuresis • Catathrenia SDB • Catathrenia • Exploding Head Syndrome • Exploding Head syndrome • Sleep Related Hallucinations • Sleep Related Hallucinations • Parasomnia, Unspecified • Parasomnia, Unspecified • Parasomnia due to Drug or • Parasomnia
    [Show full text]
  • Sleep Disorders Preeti Devnani
    SPECIAL ISSUE 1: INVITED ARTICLE Sleep Disorders Preeti Devnani ABSTRACT Sleep disorders are an increasingly important and relevant burden faced by society, impacting at the individual, community and global level. Varied presentations and lack of awareness can make accurate and timely diagnosis a challenge. Early recognition and appropriate intervention are a priority. The key characteristics, clinical presentations and management strategies of common sleep disorders such as circadian rhythm disorders, restless legs syndrome, REM behavior disorder, hypersomnia and insomnia are outlined in this review. Keywords: Hypersomnia, Insomnia, REM behavior International Journal of Head and Neck Surgery (2019): 10.5005/jp-journals-10001-1362 INTRODUCTION Department of Neurology and Sleep Disorder, Cleveland Clinic, Abu Sleep disorders are becoming increasingly common in this modern Dhabi, United Arab Emirates era, resulting from several lifestyle changes. These complaints may Corresponding Author: Preeti Devnani, Department of Neurology present excessive daytime sleepiness, lack of sleep or impaired and Sleep Disorder, Cleveland Clinic, Abu Dhabi, United Arab Emirates, quality, sleep related breathing disorders, circadian rhythm disorder e-mail: [email protected] misalignment and abnormal sleep-related movement disorders.1 How to cite this article: Devnani P. Sleep Disorders. Int J Head Neck They are associated with impaired daytime functioning, Surg 2019;10(1):4–8. increased risk of cardiovascular and cerebrovascular disease, poor Source of support: Nil glycemic control, risk of cognitive decline and impaired immunity Conflict of interest: None impacting overall morbidity and mortality. Diagnosis of sleep disorders is clinical in many scenarios, The following circadian rhythm sleep–wake disorders adapted polysomnography is a gold standard for further evaluation of from the ICSD-3: intrinsic sleep disorder such as obstructive sleep apnea (OSA) • Delayed sleep–wake phase disorder and periodic limb movement disorder (PLMD).
    [Show full text]
  • Sleep Disorders As Outlined by Outlined As Disorders Sleep of Classification N the Ribe the Features and Symptoms of Each Disorder
    CHAPTER © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 2NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORSleep SALE OR DISTRIBUTION Disorders NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Agsandrew/Shutterstock © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION CHAPTER OUTLINE EEG arousal alveolar hypoventilation paradoxical breathing idiopathic central alveolar History of Sleep Disorders© Jones & Bartlett Learning, LLCmicrognathia © Joneshypoventilation & Bartlett Learning, LLC Classification of Sleep DisordersNOT FOR SALE OR DISTRIBUTIONretrognathia NOTsnoring FOR SALE OR DISTRIBUTION Insomnia apnea–hypopnea primary snoring Sleep-Related Breathing Disorders index (AHI) sleep-related groaning Central Disorders of Hypersomnolence respiratory disturbance catathrenia Circadian Rhythm Sleep–Wake Disorders index (RDI) CPAP therapy Parasomnias respiratory effort–related positional therapy Sleep-Related© Jones Movement & Bartlett Disorders Learning, LLC arousal (RERA)© Jones & Bartletttonsillectomy Learning, LLC OtherNOT Sleep FOR Disorders SALE OR DISTRIBUTION upper-airwayNOT resistance FOR SALEadenoidectomy OR DISTRIBUTION Chapter Summary syndrome bi-level therapy excessive daytime multiple sleep latency LEARNING OBJECTIVES sleepiness (EDS) test (MSLT) sudden infant
    [Show full text]
  • The Co-Occurrence of Sexsomnia, Sleep Bruxism and Other Sleep Disorders
    Journal of Clinical Medicine Review The Co-Occurrence of Sexsomnia, Sleep Bruxism and Other Sleep Disorders Helena Martynowicz 1, Joanna Smardz 2, Tomasz Wieczorek 3, Grzegorz Mazur 1, Rafal Poreba 1, Robert Skomro 4, Marek Zietek 5, Anna Wojakowska 1, Monika Michalek 1 ID and Mieszko Wieckiewicz 2,* 1 Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] (H.M.); [email protected] (G.M.); [email protected] (R.P.); [email protected] (A.W.); [email protected] (M.M.) 2 Department of Experimental Dentistry, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] 3 Department and Clinic of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] 4 Division of Respiratory Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada; [email protected] 5 Department of Periodontology, Wroclaw Medical University, 50-367 Wroclaw, Poland; [email protected] * Correspondence: [email protected]; Tel.: +48-660-47-87-59 Received: 3 August 2018; Accepted: 19 August 2018; Published: 23 August 2018 Abstract: Background: Sleep sex also known as sexsomnia or somnambulistic sexual behavior is proposed to be classified as NREM (non-rapid eye movement) parasomnia (as a clinical subtype of disorders of arousal from NREM sleep—primarily confusional arousals or less commonly sleepwalking), but it has also been described in relation to REM (rapid eye movement) parasomnias. Methods: The authors searched the PubMed database to identify relevant publications and present the co-occurrence of sexsomnia and other sleep disorders as a non-systematic review with case series.
    [Show full text]
  • Periodic Limb Movement Disorder: Characteristics
    SLEEP SCIENCE : SLEEP , SLEEPINESS , AND SLEEPLESSNESS Kenneth Lichstein, Ph.D. Professor Emeritus Department of Psychology The University of Alabama sleeplessness II a lot can go wrong topics (among 70 sleep disorders) sleep apnea narcolepsy restless legs periodic limb movements disorders we won’t talk about exploding head syndrome sexsomnia sleep-related epilepsy catathrenia if left untreated, sleep apnea is a slow moving terminal illness Pickwickian syndrome (now called obesity-hypoventilation syndrome) obesity, daytime labored breathing, daytime sleepiness ̶ Burwell et al., 1956 10 years later sleep apnea “Nocturnal polygraphic registrations disclosed respiratory pauses…” ̶ Gastaut et al., 1966 invisible sleep apnea science advances by two processes ❑ steady, incremental, systematic research ❑ abrupt, accidental discovery o Between 1956 and 1966, 10s of thousands of PSGs had been performed world wide and no one noticed some people had quit breathing. o Bed partners were not complaining that their partner had quit breathing. when you don’t know what you are looking for, you don’t see the obvious benign snoring and sleep apnea moderate and severe snoring sleep apnea benign snoring I snoring without breath cessation ▪ occurs in 10-15% of population ▪ sleeping on back increases likelihood of snoring ▪ snorer usually has no knowledge of condition ▪ more troublesome to bed partner ▪ at 5-year follow-up, benign snoring (without weight gain) is not a risk factor for sleep apnea physiology ▪ partial airway obstruction ▪ on continuum
    [Show full text]
  • Indeling Der Slaap
    Classification of sleep disorders Prof. Dr. J. Verbraecken Multidisciplinary Sleep Disorders Centre Antwerp University Hospital University of Antwerp Prevalence Sleep disorders occur in 10% of the population impacting daily live. Most frequent: Insomnia (use of hypnotics !), Sleep related breathing disorders, Restless legs syndrome Classification sleep disorders The old classification systems (1979, 1990, 1997): according to cardinal symptom Insomnia: poor sleep Hypersomnia: too much sleep and/or EDS Parasomnia: abnormal behaviour during sleep International Classification of Sleep Disorders (2005; 2014): according to pathophysiology DSM-V (Diagnostic and Statistical Manual of Mental Disorders) ICD-10 (International Classification of Diseases - WHO) ICSD 3 (AASM): 7 categories 1. Insomnia 2. Sleep Related Breathing Disorders 3. Central Disorders of Hypersomnolence 4. Circadian Rhythm Sleep-Wake Disorders 5. Parasomnias 6. Sleep Related Movement Disorders 7. Other Sleep Disorder Appendix: Sleep Related Medical and Neurological Disorders ICSD 3 (AASM): 7 categories 1. Insomnia 10% 2. Sleep Related Breathing Disorders 3-7% or ↑ 3. Central Disorders of Hypersomnolence 0,02- 0,18% 4. Circadian Sleep-Wake Rhythm Disorders 7-16% 5. Parasomnias (children/adults) 3-17% 6. Sleep Related Movement Disorders 5-10% 7. Other Sleep Disorders Appendix: Sleep Related Medical and Neurological Disorders Insomnia Subjective: Patients suffer from poor sleep Different dimensions: Problem of initiating sleep Problem of maintaining sleep Problem of awakening too
    [Show full text]
  • Exploding Head Syndrome – the Early Steps Síndrome Da Cabeça Explodindo – Os Primeiros Passos
    CASE REPORT Exploding head syndrome – the early steps Síndrome da cabeça explodindo – os primeiros passos Elcio Juliato Piovesan1,2, Pedro André Kowacs1, Helder Granhold Campos3, Lucas Pires Augusto3, Lucas Coluni3, Lineu Cesar Werneck1,2 1Neurology Service, Internal Medicine Department, Hospital de Clínicas da Universidade Federal do Paraná (UFPR), PR, Brazil 2Experimental Laboratory, Health Sciences Sector (LESCS), Universidade Federal do Paraná (UFPR), PR, Brazil 3Faculdade de Medicina, Universidade Federal do Paraná, PR, Brazil. Sponsored by a grant from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Piovesan EJ, Kowacs PA, Campos HG, Augusto LP, Coluni L, Werneck LC Exploding head syndrome – the early steps. Headache Medicine. 2011;2(4):209-11 ABSTRACT INTRODUCTION Exploding head syndrome is a rare entity associated with migraine that occurs during sleep onset. A male migraine Exploding head syndrome (EHS) is a rare with aura patient presented with episodes of abrupt awakening phenomenon characterized by a painless loud noise at following perceptions of sounds resembling a speeding up the onset of sleep.(1) Armstrong-Jones described it for the motorcycle engine interspersed with bursts of exhaust explosions like noises, accompanied by an exploding sensation in the first time in 1920 and referred to it as "snapping of the head. The patient presented in the evolution of self-limited brain".(2) Pearce coined the name "exploding head period of headache chronicity. This syndrome has been syndrome in 1989.(3) This is a rare benign sleep-wake associated with an atypical form of acoustic aura that often transition disorder of unknown aetiology.(4) The attacks are leads to migraine chronification.
    [Show full text]
  • Parasomnias (PDF)
    Parasomnias Stephan Eisenschenk, MD Department of Neurology Parasomnias Disorders of Arousal (NREM Sleep) Confusional Arousals Sleep Walking Sleep Terrors Parasomnias Usually Associated with REM REM Behavior Disorder Recurrent isolated sleep paralysis Nightmare Disorder Other Parasomnias Sleep Related Dissociative Sleep Enuresis Sleep Related Groaning Exploding Head Syndrome Sleep Related Hallucinations Sleep Related Eating Disorder Parasomnia, Unspecified Due to Drug or Substance Stephan Eisenschenk, MD Department of Neurology Disorder of arousal- Confusional Arousals A. Recurrent mental confusion or confusional behavior occurs during an arousal or awakening from nocturnal sleep or a daytime nap Key Points Aka Sleep inertia Occurs help of Non-REM slow-wave sleep Retrograde amnesia for many intercurrent events Fragmentary or no recall of dream mentation Poor response to efforts to provoke behavioral wakefulness Episodes of mental confusion following arousal from sleep Typically from slow wave sleep in 1st third of night Sleep talking and occasional shouting is common Last 5-15 mins (can last as long as 30-40 min) Prevalent in children and adults <35 yr. 17% of children 3-13 yrs. Treatment: reassurance clonazepam rarely Stephan Eisenschenk, MD Department of Neurology Disorder of arousal- Sleepwalking (Somnambulism) A. Ambulation occurs during sleep B. Persistence of sleep, and altered state of consciousness, or impaired judgment during ambulation as demonstrated by at least one of the following: i. Difficulty in arousing the person ii. Mental confusion when awakened from an episode iii. Amnesia either complete or partial for the episode iv. Inappropriate or nonsensical behavior v. Potentially dangerous behavior Stephan Eisenschenk, MD Department of Neurology Disorder of arousal- Sleepwalking (Somnambulism) Key Points Most common in children aged 4-6 years Frequently disappears during adolescence.
    [Show full text]
  • Movement Disorders in Sleep
    Movement Disorders in Sleep Dylan Moquin BS, RST, RPSGT Sleep Program Coordinator UF Health Sleep Center Program Coordinator Santa Fe College Polysomnography Program Overview • Define Movement Disorders in Sleep • Pathophysiology • Review the various types of movement disorders • Treatment Movement Disorders in Sleep – Characterized by simple movements that disturb sleep or during the sleep onset period Types of Movement Disorders in Sleep There are ten primary sleep-related movement disorders identified in the current International Classification of Sleep Disorders 3rd Edition. Sleep-Related Movement Disorders • Restless Legs Syndrome • Propriospinal Myoclonus at • Periodic Limb Movement Sleep Onset • Sleep Related Leg Cramps • Sleep Related Movement Disorder Due to a Medical • Sleep Related Bruxism Disorder • Sleep Related Rhythmic • Sleep Related Movement Movement Disorder Disorder Due to Medication or • Benign Sleep Myoclonus of Substance Infancy • Unspecified Restless Legs Syndrome (Willis-Ekbom disease) • Sensorimotor disorder – strong need to move limbs • Urge to move legs – uncomfortable sensation – “creepy – crawly , ants, shock- like” • Worse during inactivity • Relieved by movement (depending on severity Sleep Relate Movement Disorder - RLS • Prevalence approximate 2-5% population (depending on region) • Children and Adult (increasing with age) • 2 times higher in women then men RLS and Sleep Impact • DIMS • 60-90% of patients report poor sleep quality • Daytime fatigue and sleepiness What Causes RLS? • Positive Family History • Iron Deficiency (ferritin below 50 ug/L) – Brain Iron Deficiency • Medications – antihistamines, antipsychotics and antidepressants – CNS dopamine regulation • Pregnancy (prevalence 2 -3 times higher) • Chronic Renal Failure - Uremia (40% under hemodialysis) • Strong relationship between RLS, PLMS, and ADHD (44% children) Treatment for RLS • Behavioral Modification – regular exercise, sleep hygiene, avoid exacerbating medications.
    [Show full text]
  • Evaluation of the Sleepy Child: What to Do When the Sleep Study Is Normal
    5/28/2020 Evaluation of the Sleepy Child: Objectives What to Do When the Sleep Study is Normal 1. Describe the appropriate clinical assessment of the sleepy child Stacey L. Ishman, MD • screening questions/ questionnaires Cincinnati Children’s Hospital Medical Center, • exam findings Cincinnati, OH • testing to screen for non-SDB causes of daytime sleepiness in children Thanks to: Scott Brietzke Susan Garetz Pell Wardrop 2 Objectives What We’ll Cover 2. Be familiar with the incidence, identification and impact of medical conditions that contribute to daytime tiredness including: 1) Evaluation of the sleepy child • narcolepsy • nocturnal seizures 2) Narcolepsy, RLS • restless leg syndrome 3) Circadian rhythm disorders • circadian rhythm disorders 4) Sleep hygiene 3. Recognize the importance of adequate sleep hygiene and review the components of good sleep habits 3 4 Pediatric Sleep Disorders Insomnia Sleep-related Breathing Disorders Hypersomnia (not related to breathing) Circadian Rhythm Disorder Parasomnia Sleep-Related Movement Disorders Iglowstein I, et al. Pediatrics 2003;111:302–307 1 5/28/2020 Insomnia: Sleep Disorders Sleep Disorders – Chronic insomnia (3 months) Insomnia: Psychophysiological (Conditioned) Insomnia – Short-term insomnia (<3 months) – Learned sleep preventing associations – Normal Paradoxical insomnia Short sleeper (<6 hours) – Perception of severe sleep disturbance without Excessive time in bed evidence Idiopathic insomnia – Longstanding since childhood Inadequate Sleep Hygiene – ADLs inconsistent with good sleep
    [Show full text]
  • International Classification of Sleep Disorders
    [ Contemporary Reviews in Sleep Medicine ] I n t e r n a t i o n a l C l a s s i fi cation of Sleep Disorders-Th ird Edition Highlights and Modifi cations Michael J. Sateia , MD The recently released third edition of the International Classifi cation of Sleep Disorders (ICSD) is a fully revised version of the American Academy of Sleep Medicine’s manual of sleep disorders nosology, published in cooperation with international sleep societies. It is the key reference work for the diagnosis of sleep disorders. The ICSD-3 is built on the same basic outline as the ICSD-2, identifying seven major categories that include insomnia disorders, sleep-related breathing disorders, central disorders of hypersomnolence, circadian rhythm sleep-wake dis- orders, sleep-related movement disorders, parasomnias, and other sleep disorders. Signifi cant modifi cations have been made to the nosology of insomnia, narcolepsy, and parasomnias. Major features and changes of the manual are reviewed in this article. The rationales for these changes are also discussed. CHEST 2014; 146 ( 5 ): 1387- 1394 ABBREVIATIONS : A A S M 5 American Academy of Sleep Medicine ; CRSWD 5 circadian rhythm sleep- wake disorder ; CSA 5 central sleep apnea ; CSB 5 Cheyne-Stokes breathing ; ICD 5 International Classification of Diseases ; I C S D 5 International Classification of Sleep Disorders ; I H 5 idiopathic hypersomnia ; MSLT 5 multiple sleep latency test ; NREM 5 non-rapid eye movement ; OCST 5 out-of- center sleep testing ; PAP 5 p o s i t i v e a i r w a y p r e s s u r e ; P L M 5 periodic limb movement ; PLMD 5 p e r i o d i c limb movement disorder ; PSG 5 polysomnogram ; RBD 5 rapid eye movement sleep behavior disorder ; REM 5 rapid eye movement ; RLS 5 restless legs syndrome ; SOREMP 5 sleep-onset rapid eye movement p e r i o d Th e recent publication of the third edition recommendations were added.
    [Show full text]
  • 2021 Sleep Medicine CC-MOC Content Blueprint
    Sleep Medicine Maintenance of Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified sleep medicine specialist in the broad domain of the discipline. The ability to make appropriate diagnostic and management decisions that have important consequences for patients will be assessed. The exam may require recognition of common as well as rare clinical problems for which patients may consult a certified sleep medicine specialist. The exam is developed jointly by the ABIM, the American Board of Anesthesiology, the American Board of Family Medicine, the American Board of Otolaryngology, the American Board of Pediatrics, and the American Board of Psychiatry and Neurology. Exam content Exam content is determined by a pre-established blueprint, or table of specifications, which is reviewed annually and updated as needed for currency. Trainees, training program directors, and certified practitioners in the discipline are surveyed periodically to provide feedback and inform the blueprinting process. The primary medical content categories of the blueprint are shown below, with the percentage assigned to each for a typical exam: Medical Content Category % of Exam Normal Sleep and Variants 16% Circadian Rhythm Sleep-Wake Disorders 10% Insomnia 17% Central Disorders of Hypersomnia 12% Parasomnias 7% Sleep-Related Movements 8% Sleep-Related Breathing Disorders 20% Sleep in Other Disorders 5% Instrumentation and Testing 5% 100%
    [Show full text]